Managing a full case handover from arrival to follow-up.
English for Healthcare Professionals. Lesson 12.
This is your capstone scenario: you manage one patient journey from first contact to safe follow-up. You begin with a brief triage-style conversation, confirm identity, take a focused history, and check for red flags. You then explain the next step (a test or examination) in plain English, including what the patient should expect. After that, you deliver a structured handover to a colleague, and you finish by giving a short discharge-style plan with safety-netting.
The aim is integration. You will reuse your core chunk bank across different moments and switch register smoothly: more clinical language with colleagues, clearer everyday language with the patient. You will also practise calm, confident delivery under pressure, including clarifying missing information and confirming numbers and timings. You end with a final review that re-activates your highest-value phrases and patterns, so you leave with a reliable set of language you can use on your next shift.
1. First contact at triage: open and confirm identity.
Today is your capstone, so we’re going to follow one patient journey from first contact to safe follow-up. Imagine you’re in urgent care and you’ve just called the next patient. Your first job is to sound calm and structured, even if it’s busy. In the first minute, you need to do three things well: greet the patient and introduce your role, confirm identity using at least two identifiers, and set expectations for what will happen next. This is not just “nice language”; it is patient safety language.
As you work through this lesson, keep one idea in mind: the words you choose can reduce risk. Clear identity checks stop mix-ups. Clear signposting reduces anxiety. And when a patient is vague or stressed, polite clarification helps you get reliable information.
In this first block, you’ll watch a short triage-style opening, then you’ll write your own opening. Focus on a warm, professional tone and simple, safe checks.
Capstone case: the patient’s journey starts here.
You’re working in an English-medium urgent care unit. It’s busy, but you still need to keep your communication patient-safe. The patient you’re about to see is Samira Khan, who has come in because she feels unwell and worried.
In the first 60–90 seconds, a strong triage opening has a clear structure:
Greet + introduce your role (so the patient knows who you are).
Confirm identity using two identifiers (usually full name + date of birth). If appropriate, add address or NHS number.
Signpost what will happen next (short, calm, realistic time language).
Model opening (what “good” sounds like).
Notice how the clinician keeps sentences short, uses polite requests, and explains why the check is happening.
Clinician: Hello, my name’s Dr Patel. I’m one of the clinicians in urgent care today.
Patient: Hi.
Clinician: Could I just confirm your full name, please?
Patient: Samira Khan.
Clinician: Thank you. And your date of birth?
Patient: 14th of March 1989.
Clinician: Great. We do these checks for everyone, for safety.
Clinician: Let’s start with the main problem today. I’m going to ask a few focused questions to make sure it’s safe, and then we’ll decide the next step. If anything I say isn’t clear, please stop me. Is it OK if we begin?
Noticing: high-value phrases to recycle.
These chunks are useful because they are polite, clear, and easy to repeat under pressure:
“Could I just confirm your full name, please?”
“And your date of birth?”
“We do these checks for everyone, for safety.”
“Let’s start with the main problem today.”
“I’m going to ask a few focused questions to make sure it’s safe.”
“If anything I say isn’t clear, please stop me.”
Mini-check: what makes it safe?.
A safe opening is not long. It is complete:
identity checked clearly
reason for checks explained
patient invited to ask questions
permission to begin
In the activity, you’ll write your own opening in your own style, but keep the same safety structure.
Practice & Feedback
Write your triage opening to Samira Khan. Imagine she has just sat down. Write 6–9 lines (like a mini script) in your voice as the clinician.
Include:
a greeting and your role;
two identity checks (full name + date of birth);
one sentence explaining why you check identity;
a signpost sentence for what will happen next (short and calm);
one checking/permission question (for example, “Is it OK if we begin?”).
Keep it friendly and professional. Don’t start taking the history yet; this is only the opening and identity check.
Useful chunks (you can copy and adapt).
“Hello, I’m one of the clinicians on the team.”
“Could I just confirm your full name, please?”
“And your date of birth?”
“We do these checks for everyone, for safety.”
“Let’s start with the main problem today.”
“I’m going to ask a few focused questions to make sure it’s safe.”
“If anything I say isn’t clear, please stop me.”
“Is it OK if we begin?”
2. Focused triage questions: symptoms, time and red flags.
Now that you’ve opened the interaction safely, we move into the triage core: finding out what’s going on quickly, without sounding rushed or interrogative. In urgent care, you’re balancing two things at the same time. You want the patient to speak freely, because you might miss something important if you only ask yes-or-no questions. But you also need to funnel the conversation towards key details: what the symptom is, when it started, how bad it is, and whether there are any red flags.
In this block you’ll listen to a short triage exchange. While you listen, pay attention to two techniques. First, notice how the clinician clarifies vague words with options: for example, “dizzy” can mean different things. Second, notice the calm explanation: “I’m asking these questions to make sure we don’t miss anything serious.” That sentence reduces alarm, but it also justifies your direct questions.
After the listening, you’ll answer a few comprehension questions and extract the key facts like you would in real notes.
The triage moment: fast, calm, and accurate.
You’ve confirmed identity. Next, you need a short, focused triage history. The aim is not a full diagnosis. The aim is a safe summary: what is happening, when it started, what it feels like, and whether anything suggests a serious problem.
In triage, vague words are common:
“dizzy”
“tight chest”
“funny vision”
“really bad headache”
A safe clinician does two things:
Clarifies with simple options.
Checks red flags with a calm reason.
Listening scene: Samira at triage.
In the audio you’ll hear Samira explain her symptoms. Your job is to listen for:
symptom description (in everyday language)
timeline (start time, duration)
severity or impact
red flags (what was asked, what was denied)
key numbers and times
Noticing language patterns.
Here are high-value patterns from this unit that keep you calm and precise:
Clarifying options
“When you say ‘dizzy’, do you mean the room is spinning or you feel faint?”
“Is the pain constant, or does it come and go?”
Confirming times
“Just to confirm, this started this morning at about…?”
“When did it start exactly?”
Red flags with reassurance
“I’m asking these questions to make sure we don’t miss anything serious.”
“Have you had any chest pain or shortness of breath?”
What you will do next.
After you listen, you’ll write a short triage note-style summary: two or three sentences with the key facts. This is good practice for later in the lesson when you have to deliver an SBAR update and a discharge plan.
Take your time with numbers and timings. In real clinical English, accuracy beats speed.
Practice & Feedback
Listen to the triage audio and do two things:
Answer the comprehension questions in full sentences (short is fine, but be clear).
Then write a 2–3 sentence triage summary of what Samira reported. Include: the main symptom(s), when it started, and one relevant red-flag answer (for example, what she denies).
Aim for calm, factual language. If you are unsure about one detail, write it as uncertain (for example, “around 8 am” or “approximately”).
3. Explain the next step: test or examination in plain English.
You’ve got a clear triage picture. Now you need to tell Samira what happens next, in everyday language, and with good consent habits. In urgent care, even simple examinations can worry a patient, especially when they’re dizzy or frightened. Your job is to keep your explanation structured: purpose first, then steps, then what it might feel like, then safety checks, then questions, then consent.
Notice that ‘consent’ here is not a formal signature moment; it’s a communication pattern. You explain, you check understanding, you invite questions, and you confirm they’re happy to proceed. You also set expectations: how long it will take and what happens after.
In this case, we’ll choose a realistic next step after dizziness: checking observations and doing an ECG and a finger-prick blood sugar. That gives you a great chance to practise clear sequencing language: first, next, then, after that. In the activity, you’ll write what you would say to Samira to explain the plan and get her agreement.
From triage to next step: explain, then check.
A patient can accept a plan more easily when you explain it clearly. In urgent care, your explanation needs to be:
You do not need to promise a diagnosis. You can communicate uncertainty safely.
Model explanation (plain English).
Clinician: The next step is to check your observations and do a couple of quick tests. The aim is to make sure there isn’t a medical cause we need to treat urgently.
Clinician: First, I’ll check your blood pressure, pulse and oxygen level. Then we’ll do an ECG, which is a simple heart tracing. It shouldn’t be painful, but the stickers can feel a bit cold.
Clinician: After that, I’d like to do a finger-prick blood sugar test. You’ll feel a small scratch, and it’s over in a second.
Clinician: Does that make sense so far? What questions do you have at this point?
Clinician: If you’re happy, we can go ahead.
Useful chunks to keep your tone calm.
“I’m going to explain what will happen step by step.”
“The aim of this test is to…”
“It should not be painful, but you may feel…”
“If anything is too uncomfortable, tell me straight away.”
“Does that make sense so far?”
“Are you happy for us to go ahead?”
Small but important register tip.
With patients, prefer everyday explanations:
ECG → “a heart tracing” / “a tracing of your heart rhythm”
observations → “your vital signs, like blood pressure and pulse”
In the activity, you’ll write a short explanation in your own words. Keep it realistic: 45–60 seconds of speaking.
Practice & Feedback
Write what you would say to Samira to explain the next step and gain consent. Write 120–170 words.
Include:
one sentence that signposts (“The next step is…”) and gives a reason (“The aim is…”);
a step-by-step sequence using “first / then / after that”;
one comfort/sensation sentence (for example, “It shouldn’t be painful, but…”);
one understanding check (“Does that make sense so far?”);
one invitation for questions;
a consent/permission question at the end.
Keep the language patient-friendly and calm. Avoid overpromising (don’t say “This will definitely show…”).
Phrase bank for this step.
“The next step is…, and I’ll explain what to expect.”
“The aim of this test is to…”
“First…, then…, and after that…”
“It should not be painful, but you may feel…”
“If anything is too uncomfortable, tell me straight away.”
“Does that make sense so far?”
“What questions do you have at this point?”
“Are you happy for us to go ahead?”
4. Call a colleague: deliver a concise SBAR and request.
At this point in the journey, you’ve triaged Samira and planned initial tests. Now we switch register: colleague-facing language. This is where many internationally trained clinicians feel the pressure, because you need to be both concise and clear. A good SBAR is not a story; it’s a structured update with a clear ask.
In this block, you’ll read a model phone update to a senior clinician. Pay attention to how it opens: name, location, and permission to give a quick SBAR. Then notice how each SBAR section contains only the most relevant facts, including timings. Finally, notice the recommendation: the clinician clearly asks for a review and confirms the plan.
When you write your own SBAR, keep it short and factual. Use cautious certainty where appropriate: “likely”, “can’t rule out”, “I’m concerned because”. That sounds professional, and it protects patient safety.
After you draft your SBAR, you’ll get feedback on structure, clarity, and how natural it sounds on the phone.
Switching register: patient-friendly to colleague-facing.
With Samira, you used plain English and reassurance. With a colleague, you can be more clinical and compressed. The skill is switching smoothly without becoming cold.
SBAR gives you a reliable structure:
Situation: who you are, where you are, who the patient is, and what is happening now.
Background: relevant history and context (only what matters).
Assessment: what you think is going on, observations/tests so far, and why you are concerned.
Recommendation: what you want the colleague to do, by when, and what you will do next.
Model phone SBAR (reading).
Read it once for meaning. Then read again and underline: (1) time phrases, (2) cautious certainty, (3) the clear request.
Caller (you): Hello, this is Dr Patel calling from urgent care. Is now a good time for a quick SBAR update?
S: I’m calling about Samira Khan, 35, who presented with intermittent light-headedness since around 08:00 today.
B: No chest pain or shortness of breath. No focal neurological symptoms reported. No collapse, but she felt close to fainting.
A: Currently stable, but I’m concerned because the onset was sudden and she’s had three to four episodes today. I’m arranging observations, an ECG and a finger-prick glucose. At this stage it’s likely benign, but I can’t rule out a cardiac or metabolic cause yet.
R: I’d like you to review her within the next hour and advise on next steps. Can I just confirm the plan: I will complete the ECG and observations now, and I’ll update you immediately if there’s any deterioration?
Micro-tips that improve your SBAR instantly.
A strong SBAR often includes:
one clear time anchor (“since around 08:00”)
one clear concern sentence (“I’m concerned because…”)
one clear request with timeframe (“within the next hour”)
one plan confirmation (“Can I just confirm the plan…?”)
Now you’ll write your own SBAR based on the same scenario. Keep it tight: about 90–120 words.
Practice & Feedback
Write a short phone SBAR to a senior clinician about Samira. Write 90–120 words.
Include:
a professional opening line (who you are + where you’re calling from);
S: main problem + timeline;
B: 1–2 relevant negatives (for example, no chest pain / no neuro symptoms);
A: your concern + what you are doing now (tests/observations);
R: a clear request with a timeframe + a plan confirmation sentence.
Aim for colleague-facing language: concise, structured, factual. If something is uncertain, show that safely (for example, “at this stage it’s likely…, but I can’t rule out…”).
SBAR chunks to reuse.
“Hello, this is … calling from …”
“Is now a good time for a quick SBAR update?”
“I’m calling about a patient with…”
“The situation is…”
“The background is…”
“My assessment is…”
“I’m concerned because…”
“I’d like you to review within the next…”
“Can I just confirm the plan: you will…, and I will…”
“I’ll document this and update you if anything changes.”
5. Patient chat simulation: explain plan and safety-net.
Now we move back to the patient. In real life, after tests or an initial review, you often need to communicate a plan before the patient leaves: what you think is going on, what you’re advising, and very importantly, what to watch for. This is safety-netting. It protects the patient, and it protects you, because you’re making the boundaries of the plan clear.
In this block we’ll do a short chat-style simulation. You are the clinician, and I will act as Samira. Your goal is to keep a calm, human tone while still being structured. Use signposting: “To summarise, the plan is…” Then give practical advice with timeframes. Finally, ask for teach-back: “Just so I know I’ve explained it clearly, what will you do if…?” That question often reveals misunderstandings before they become risk.
To keep the case realistic, we’ll assume her immediate tests are reassuring, but you still can’t promise everything. You’ll give advice for hydration, slow position changes, and follow-up with GP, and you’ll safety-net for chest pain, fainting, new neurological symptoms, or worsening symptoms.
Write it like a live chat: short messages, clear questions, and supportive language.
Safety-netting in plain English: what to say and how to say it.
Safety-netting is not fear-mongering. It’s calm, practical information: what is normal, what is not, and what to do next.
In this scenario, Samira’s initial checks are reassuring. You can communicate that with balanced language:
“Overall, this looks reassuring.”
“At this stage, it’s likely that…”
“We can’t rule out … yet, so the next step is…”
A helpful structure for a patient-facing plan.
You can use this simple 4-part pattern:
Headline: “The main message is…”
Plan: “To summarise, the plan is…” (2–3 steps)
Safety-net: “If you notice…, seek help straight away.”
Teach-back: “Just so I know I’ve explained it clearly, what will you do if…?”
Model chat-style messages (short, clear).
Clinician: Thanks, Samira. Overall, your initial checks look reassuring.
Clinician: To summarise, the plan is: drink plenty of fluids today, stand up slowly, and avoid driving until you feel steady.
Clinician: We’ll arrange a follow-up with your GP in the next 48 hours. If your symptoms are not improving by then, please contact them sooner.
Clinician: If you develop chest pain, shortness of breath, you faint, or you notice weakness, slurred speech or changes in vision, please seek urgent help immediately.
Clinician: Just so I know I’ve explained it clearly, what will you do if you feel like you’re going to faint again?
Register reminder.
With patients: “faint”, “feel breathless”, “changes in vision”
With colleagues: “syncope”, “SOB”, “neurological deficit”
In the next activity you’ll run the conversation as a mini chat. Keep your messages short and natural, but make sure the safety-net is specific.
Practice & Feedback
Let’s do a chat-style simulation. You are the clinician and I am Samira.
Write 6–10 short chat messages (each 1–2 sentences). Your messages should:
reassure carefully (without promising certainty);
summarise the plan in 2–3 steps with timeframes;
include clear safety-netting (what to watch for + what action to take);
include one teach-back question (“Just so I know I’ve explained it clearly…”).
Write as if you are typing in a clinical messaging tool: calm, simple, and patient-friendly. Avoid long paragraphs.
Safety-netting chunks.
“Overall, this looks reassuring.”
“At this stage, it’s likely that…”
“We can’t rule out… yet, so the next step is…”
“To summarise, the plan is…”
“If you notice…, please seek urgent help immediately.”
“Just so I know I’ve explained it clearly, what will you do if…?”
“Is there anything you’re unsure about before you go?”
6. Final integration: document the journey in a brief note.
You’ve now practised the whole communication chain: opening and identity checks, focused triage questioning, explaining tests, SBAR to a colleague, and a patient-facing plan with safety-netting. The final piece is documentation. In a real shift, if it isn’t documented clearly, it’s very hard for the next clinician to see what happened, and it increases risk.
In this last block, you’ll write a compact end-to-end note that mirrors the patient journey. Think of it as a hybrid between a triage note and a brief SBAR-style record: it should include who the patient is, what they presented with, key negatives, what you did, what you told the patient, and what the follow-up and safety-net advice was.
Good documentation is not fancy English. It is clear English with accurate times, numbers, and sensible certainty. Use phrases like “reports”, “denies”, “no”, “plan”, and “advised”. Keep it readable. And make sure the safety-netting is visible, not hidden.
When you finish, you’ll be able to compare your note against a mini rubric: structure, key facts, and safe next steps.
Capstone output: one brief, defensible clinical note.
This is your integrated performance for the lesson. You will write a short note that captures the whole journey:
first contact and identity confirmation
focused symptoms + timeline + red flags
next step explained (tests/examination)
colleague handover intention (SBAR elements)
discharge-style plan + safety-netting + teach-back
Documentation conventions to keep it safe.
Times and dates: be consistent.
“08:00” (24-hour clock) is clear.
If approximate: “~08:00” or “around 08:00”.
Certainty: don’t overstate.
“likely” / “appears” / “cannot rule out yet” are safer than “definitely”.
Plain English vs clinical shorthand: in notes you can be more clinical than with a patient, but keep it readable.
